NPIMap

Organization Active NPI

Path Medical, LLC

Doing business as Path Medical - North Tampa

  • Rehabilitation Clinic/Center
  • Tampa, FL
National Provider Identifier
1386185189
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PATH MEDICAL, LLC
Doing business as
Path Medical - North Tampa
Practice address
14824 N Florida Ave Ste a
Tampa, FL 33613-1844
Phone
(813) 549-4480
Fax
(813) 549-4485
NPI assigned
Mar 13, 2017
Organization subpart
Yes
Parent organization
PATH MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Neil Bonnardel, MD
Title
Director of Medical Services
Phone
(754) 218-2164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

14824 N Florida Ave Ste a
Tampa, FL 33613-1844

Mailing address

2304 W Oakland Park Blvd
Oakland Park, FL 33311-1422
Phone (754) 218-2164

Other names 1

  • Path Medical - North Tampa Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Path Medical LLC24 organizations share this tax ID, including this one
Part of
Path Medical LLC

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

14824 N Florida Ave
#A
Tampa, FL 33613
Phone (813) 549-4480

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1386185189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 W OAKLAND PARK BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111422",
            "telephone_number": "754-218-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14824 N FLORIDA AVE STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131844",
            "telephone_number": "813-549-4480",
            "fax_number": "813-549-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH MEDICAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATH MEDICAL",
        "enumeration_date": "2017-03-13",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "BONNARDEL",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "DIRECTOR OF MEDICAL SERVICES",
        "authorized_official_telephone_number": "754-218-2164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Path Medical - North Tampa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Path Medical - North Tampa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.